title: Are depressive symptoms more common among British South Asian patients compared with British White patients with cancer? A cross-sectional survey.
abstract: OBJECTIVE
  This cross-sectional survey investigated whether there were ethnic differences in depressive symptoms among British South Asian (BSA) patients with cancer compared with British White (BW) patients during 9 months following presentation at a UK Cancer Centre. We examined associations between depressed mood, coping strategies and the burden of symptoms.
  
  
  METHODS
  Questionnaires were administered to 94 BSA and 185 BW recently diagnosed patients with cancer at baseline and at 3 and 9 months. In total, 53.8% of the BSA samples were born in the Indian subcontinent, 33% in Africa and 12.9% in the UK. Three screening tools for depression were used to counter concerns about ethnic bias and validity in linguistic translation. The Hospital Anxiety and Depression Scale (HADS-D), Patient Health Questionnaire-9 (both validated in Gujarati), Emotion Thermometers (including the Distress Thermometer (DT), Mini-MAC and the newly developed Cancer Insight and Denial questionnaire (CIDQ) were completed.
  
  
  METHODS
  Leicestershire Cancer Centre, UK.
  
  
  METHODS
  94 BSA and 185 BW recently diagnosed patients with cancer.
  
  
  RESULTS
  BSA self-reported significantly higher rates of depressive symptoms compared with BW patients longitudinally (HADS-D ≥8: baseline: BSA 35.1% vs BW 16.8%, p=0.001; 3 months BSA 45.6% vs BW 20.8%, p=0.001; 9 months BSA 40.6% vs BW 15.3%, p=0.004). BSA patients used potentially maladaptive coping strategies more frequently than BW patients at baseline (hopelessness/helplessness p=0.005, fatalism p=0.0005, avoidance p=0.005; the CIDQ denial statement 'I do not really believe I have cancer' p=0.0005). BSA patients experienced more physical symptoms (DT checklist), which correlated with ethnic differences in depressive symptoms especially at 3 months.
  
  
  CONCLUSIONS
  Health professionals need to be aware of a greater probability of depressive symptomatology (including somatic symptoms) and how this may present clinically in the first 9 months after diagnosis if this ethnic disparity in mental well-being is to be addressed.
authors.affiliation: Department of Oncology, University Hospitals of Leicester NHS Trust, Leicester, UK.
authors.forename: Karen
authors.initials: K
authors.lastname: Lord
authors.forename: Kausher
authors.initials: K
authors.lastname: Ibrahim
authors.forename: Sawan
authors.initials: S
authors.lastname: Kumar
authors.forename: Alex J
authors.initials: AJ
authors.lastname: Mitchell
authors.forename: Nicky
authors.initials: N
authors.lastname: Rudd
authors.forename: R Paul
authors.initials: RP
authors.lastname: Symonds
keywords: Depression; Ethnicity; Mental Health